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Abstract: SA-OR39

Effect of a Nutritional Supplement of Probiotics and/or Prebiotics vs. Placebo on Nutritional Status in Automated Peritoneal Dialysis (APD) Patients

Session Information

Category: Health Maintenance‚ Nutrition‚ and Metabolism

  • 1400 Health Maintenance‚ Nutrition‚ and Metabolism

Authors

  • Martin del Campo, Fabiola, Hospital de Especialidades del Centro Medico Nacional de Occidente IMSS, Guadalajara, Jalisco, Mexico
  • Cueto-Manzano, Alfonso M., Hospital de Especialidades del Centro Medico Nacional de Occidente IMSS, Guadalajara, Jalisco, Mexico
  • Sanchez-Ramirez, Carmen, Universidad de Colima Facultad de Medicina, Colima, Colima, Mexico
  • Vega, Natali, Departamento de Microbiología y Patología, Universidad de Guadalajara, Guadalajara, Mexico
  • Peña Rodríguez, Marcela, Universidad de Guadalajara Departamento de Biologia Molecular y Genomica, Guadalajara, Jalisco, Mexico
  • Cortes-Sanabria, Laura, Hospital de Especialidades del Centro Medico Nacional de Occidente IMSS, Guadalajara, Jalisco, Mexico
  • Rojas-Campos, Enrique, Hospital de Especialidades del Centro Medico Nacional de Occidente IMSS, Guadalajara, Jalisco, Mexico
  • Villasana Ballesteros, Mariana, Hospital de Especialidades del Centro Medico Nacional de Occidente IMSS, Guadalajara, Jalisco, Mexico

Group or Team Name

  • Unidad de Investigación Médica en Enfermedades Renales
Background

Prebiotics and probiotics may improve nutritional status in dialysis patients by decreasing inflammation and intestinal production of uremic toxins; however, no study has been performed comparing these interventions altogether and separately. Aim: to evaluate the effect of a supplement of probiotics and/or prebiotics vs placebo on nutritional status in APD.

Methods

Randomized, triple blinded, controlled, clinical trial in 64 clinically stable APD patients, assigned to: Probiotic (2x108 CFU probiotics+placebo); Prebiotic (20g inulin+placebo); Simbiotic (2x108 CFU probiotics+20g inulin); or Placebo (placebo+placebo) during 3 months. Nutritional status determined by subjective global assessment (SGA). Intestinal microbiota was evaluated with 16S rRNA gene sequency.

Results

Nutritional status results shown in Figure. Prebiotic group increased SGA score (5.1±1.1 vs 5.9±0.7, p=0.02), dietary intake of energy (1121±373 vs 1508±637, p=0.02) and marginally fiber (17±7 vs 24±12, p=0.08); Probiotic marginally increase SGA (5.6±1.0 vs 6.1±0.7, p=0.06); no statistical differences were observed in Symbiotic and Placebo groups. At the end of the study, Prebiotic significantly increased relative abundance of Blautia, Ruminococcaceae and Faecalibacterium prausnitzii bacteria and decreased Clostridiales; compared to placebo, Prebiotic showed higher predominance of Succinivibrio, Aeromonadales, Bifidobacterium, Bifidobacteriales and SMB53 at final evaluation.
Adherence to treatment was >90% in all groups during the study; main adverse effects were mild gastrointestinal symptoms (not significantly different between groups).

Conclusion

Prebiotic improve nutritional status and intestinal microbiota in APD patients; this could be an easy and inexpensive intervention for this patients.